Jiménez-Mola Sonia, Plaza-Carmona María, Idoate Gil Francisco Javier, Sáez-López Pilar, Fernández García Paula, Seco-Calvo Jesús
University Health Care Complex of León - León, Spain.
University Health Care Complex of León, Universidad Internacional de la Rioja - León, Spain.
Rev Assoc Med Bras (1992). 2025 Mar 17;71(1):e20240796. doi: 10.1590/1806-9282.20240796. eCollection 2025.
The objective of this study was to determine the characteristics of nonagenarian patients admitted for hip fracture and assess whether they present differences in complications and functional outcomes at discharge compared to younger patients.
Prospective longitudinal study in patients over 75 years of age admitted for hip fracture over a 1-year period. A total of 542 patients were included, of which 165 patients were aged over 90 years (30.9%). Demographic variables, pre-fracture functional status, medical history, type of fracture, functional evolution, discharge destination, and mortality were collected. Differences between the two population groups were analyzed.
Of the 542 patients over 75 years admitted for hip fracture, 165 were aged over 90 years (30.9%), 74.5% were women, 62% were independently ambulatory prior to the fracture, and 70% had a Barthel Index score >60. Cognitive impairment was absent in 49% of cases. Surgical treatment was performed in 91.5% of cases. There were no differences in the baseline status when compared to younger patients (aged 75-89 years) except for a higher likelihood of residing in a nursing home (OR 1.74; CI 1.18-2.55). Nonagenarian patients were at higher risk of not being able to walk at discharge (OR 2.00; CI 1.29-3.10). Discharge to a nursing home or functional recovery unit was more likely (OR 1.85; CI 1.22-2.81).
Patients over 90 years of age are more susceptible to worsening their function during admission and have a higher risk of not being able to walk at discharge. Efforts should be made to reverse this decline in order to reduce the associated mortality.
本研究的目的是确定因髋部骨折入院的九旬患者的特征，并评估与年轻患者相比，他们在出院时的并发症和功能结局是否存在差异。
对1年内因髋部骨折入院的75岁以上患者进行前瞻性纵向研究。共纳入542例患者，其中165例年龄超过90岁（30.9%）。收集人口统计学变量、骨折前功能状态、病史、骨折类型、功能演变、出院目的地和死亡率。分析两组人群之间的差异。
在542例因髋部骨折入院的75岁以上患者中，165例年龄超过90岁（30.9%），74.5%为女性，62%在骨折前能够独立行走，70%的巴氏指数评分>60。49%的病例无认知障碍。91.5%的病例进行了手术治疗。与年轻患者（75-89岁）相比，除了入住养老院的可能性更高（比值比1.74；可信区间1.18-2.55）外，基线状态无差异。九旬患者出院时无法行走的风险更高（比值比2.00；可信区间1.29-3.10）。更有可能出院后入住养老院或功能康复单元（比值比1.85；可信区间1.22-2.81）。
90岁以上的患者在住院期间功能更容易恶化，出院时无法行走的风险更高。应努力扭转这种下降趋势，以降低相关死亡率。
